Effects of ivabradine therapy on heart failure biomarkers
| Autor: | Hakan Özhan, Harun Evrengul, Havane Asuman Kaftan, Mehmet Tosun, Serkan Ordu, Yusuf Izzettin Alihanoglu, Aybars Ozsoy, Bekir Serhat Yildiz |
|---|---|
| Přispěvatelé: | BAİBÜ, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Tosun, Mehmet |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
demography glomerulus filtration rate Time Factors Turkey heart failure medical record review Ventricular Function Left chemistry.chemical_compound Heart Rate cystatin C blood analysis time factor middle aged Natriuretic Peptide Brain Natriuretic peptide Ivabradine Prospective Studies CA-125 New York Heart Association class pathophysiology Ejection fraction pro-brain natriuretic peptide (1-76) biology benzazepine derivative quantitative analysis adult creatinine General Medicine biological marker CST3 protein human aged female Treatment Outcome heart stroke volume Cardiology Cardiology and Cardiovascular Medicine down regulation medicine.drug prospective study medicine.medical_specialty CA 125 antigen medicine.drug_class Renal function Down-Regulation brain natriuretic peptide systolic heart failure ivabradine NT-proBNP cystatin-C Article blood Internal medicine Heart rate medicine follow up Humans controlled study human Creatinine business.industry disease association Systolic Heart Failure Aged Benzazepines/*therapeutic use Biomarkers/blood CA-125 Antigen/*blood Cardiovascular Agents/*therapeutic use Cystatin C/*blood Female Heart Failure Systolic/blood/diagnosis/*drug therapy/physiopathology Heart Rate/drug effects Middle Aged Natriuretic Peptide Brain/*blood Peptide Fragments/*blood Stroke Volume/drug effects Ventricular Function Left/drug effects Cardiovascular Agents Stroke Volume clinical assessment Benzazepines medicine.disease major clinical study Cystatin-C Peptide Fragments Cystatin C chemistry peptide fragment Heart failure biochemical marker cardiovascular agent drug effects CA-125 Antigen randomized controlled trial biology.protein heart left ventricle function business Biomarkers Systolic heart failure heart left ventricle ejection fraction Heart Failure Systolic |
| Popis: | WOS: 000364706900007 PubMed: 25733317 Background: Heart rate (HR) reduction is associated with improved outcomes in patients with heart failure (HF) and biomarkers can be a valuable diagnostic tool in HF management. The primary aim of our study was to evaluate the short-term (6 months) effect of ivabradine on N-terminal pro B-type natriuretic peptide (NT-proBNP), CA-125, and cystatin-C values in systolic HF outpatients, and secondary aim was to determine the relationship between baseline HR and the NT-proBNP, CA-125, cystatin-C, and clinical status variation with ivabradine therapy. Methods: Ninety-eight patients (mean age: 65.81 +/- 10.20 years; 33 men), left ventricular ejection fraction < 35% with Simpson method, New York Heart Association (NYHA) class II-III, sinus rhythm and resting HR > 70/min, optimally treated before the study were included. Among them, two matched groups were formed: the ivabradine group and the control group. Patients received ivabradine with an average (range of 10-15) mg/day during 6 months of follow-up. Blood samples for NT-proBNP, CA-125, and cystatin-C were taken at baseline and at the end of a 6-month follow-up in both groups. Results: There was a significant decrease in NYHA class in the ivabradine group (2.67 +/- +/- 0.47 vs. 1.85 +/- 0.61, p < 0.001). When ivabradine and control groups were compared, a significant difference was also found in NHYA class 6 months later (p = 0.013). A significant decrease was found in HR in the ivabradine and control groups (84.10 +/- 8.76 vs. 68.36 +/- +/- 8.32 bpm, p = 0.001; 84.51 +/- 10 vs. 80.40 +/- 8.3 bpm, p = 0.001). When both groups were compared, a significant difference was also found in HR after 6 months (p = 0.001). A significant decrease was found in cystatin-C (2.10 +/- 0.73 vs. 1.50 +/- 0.44 mg/L, p < 0.001), CA-125 (30.09 +/- 21.08 vs. 13.22 +/- 8.51 U/mL, p < 0.001), and NT-proBNP (1,353.02 +/- 1,453.77 vs. 717.81 +/- 834.76 pg/mL, p < 0.001) in the ivabradine group. When ivabradine and control groups were compared after 6 months, a significant decrease was found in all HF parameters (respectively; cystatin-C: p = 0.001, CA-125: p = 0.001, NT-proBNP: p = 0.001). Creatinine level was significantly decreased and glomerular filtration rate (GFR) was significantly increased in the ivabradine group (1.02 +/- 0.26 vs. 0.86 +/- 0.17, creatinine: p = 0.001; 79.26 +/- +/- 18.58 vs. 92.48 +/- 19.88, GFR: p = 0.001). There was no significant correlation between NYHA classes (before and after ivabradine therapy) and biochemical markers, or HR. Conclusions: In the outpatients with systolic HF, persistent resting HF > 70/min with optimal medical therapy, the NT-proBNP, CA-125, and cystatin-C reductions were obtained with ivabradine treatment. Measurement of NT-proBNP, CA-125, and cystatin-C may prove to be useful in biomarker panels evaluating ivabradine therapy response in HF patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|